Anemia and low-grade inflammation in pediatric kidney transplant recipients

Miettinen, Jenni; Tainio, Juuso; Jahnukainen, Timo; Pakarinen, Mikko P.; Lauronen, Jouni; Jalanko, Hannu

doi:10.1007/s00467-016-3481-7

Cited by 4 publications

(9 citation statements)

References 45 publications

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“…Most of the RTx recipients (79%) enrolled in our study underwent transplantation more than a year ago; thus this study mainly focused on “late” PTA. We found that the prevalence of anemia in the RTx group was 46% and similar to previous studies on PTA indicating the prevalence ranging between 22% and 82% in pediatric patients 7‐12 …”

Section: Discussionsupporting

confidence: 89%

“…We found that the prevalence of anemia in the RTx group was 46% and similar to previous studies on PTA indicating the prevalence ranging between 22% and 82% in pediatric patients. [7][8][9][10][11][12] In the RTx group, Hb concentration was positively correlated with eGFR. Moreover, anemic patients had lower levels of eGFR than non-anemic individuals.…”

Section: Ta B L Ementioning

confidence: 93%

“…Even though the renal function and so the endogenous production of EPO increases after transplantation, anemia remains a serious clinical problem with the varying prevalence of 22%-82% in pediatric RTx recipients. [7][8][9][10][11][12] Although similar factors play a role in both PTA and anemia in native CKD patients, studies have shown that patients with CKD following renal transplantation have lower Hb levels for any given level of kidney function compared with pretransplant CKD patients, suggesting anemia in renal allograft recipients is driven by additional factors such as the inhibiting effects of immunosuppressive treatments on erythropoiesis, episodes of rejections, or altered inflammatory milieu. 13 There are studies assessing anemia of RTx recipients in the pediatric population, but as far as we know there is no study focused on the transplantation-related causes of anemia by comparing RTx recipients with kidney function matched CKD patients.…”

Section: Introductionmentioning

confidence: 99%

“…The primary risk factor for the development of anemia in this population is the severity of CKD. Even though the renal function and so the endogenous production of EPO increases after transplantation, anemia remains a serious clinical problem with the varying prevalence of 22%‐82% in pediatric RTx recipients 7‐12 . Although similar factors play a role in both PTA and anemia in native CKD patients, studies have shown that patients with CKD following renal transplantation have lower Hb levels for any given level of kidney function compared with pretransplant CKD patients, suggesting anemia in renal allograft recipients is driven by additional factors such as the inhibiting effects of immunosuppressive treatments on erythropoiesis, episodes of rejections, or altered inflammatory milieu 13 …”

Section: Introductionmentioning

confidence: 99%

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Anemia after kidney transplantation: Does its basis differ from anemia in chronic kidney disease?

Oruc

Canpolat

Pehlivan

et al. 2020

Pediatric Transplantation

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Background: Although similar factors play a role in both PTA and anemia in patients with CKD, additional risk factors exist in the pathogenesis of PTA. The present study aimed at comparing anemia and inflammation-related parameters between RTx recipients and CKD patients and elucidating the risk factors of PTA. Methods: This single-centered, cross-sectional study consisted of 68 participants: 48 were in the RTx group and 20 were in the CKD group. The CKD patients were comparable to the RTx recipients in terms of age, gender, and eGFR. Serum levels of EPO, hepcidin, and IL-6 were measured by enzyme-linked immunosorbent assays. The ratio of EPO/Hb was calculated to estimate endogenous EPO resistance. Results: The prevalence of anemia was 46% in the RTx group and 30% in the CKD group (P = .23). RTx recipients had significantly lower Hb (P = .04), higher EPO

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Section: Discussionsupporting

confidence: 89%

Section: Ta B L Ementioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Anemia after kidney transplantation: Does its basis differ from anemia in chronic kidney disease?

Oruc

Canpolat

Pehlivan

et al. 2020

Pediatric Transplantation

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show abstract

“…In pediatric kidney transplant recipients, anemia is common [1][2][3][4][5][6] and associated with worse allograft function [5,6]. The etiology of post-transplant anemia is oftentimes complex and multifactorial.…”

Section: Introductionmentioning

confidence: 99%

Associations among erythropoietic, iron-related, and FGF23 parameters in pediatric kidney transplant recipients

et al. 2021

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Background-In pediatric kidney transplant recipients, anemia is common and oftentimes multifactorial. Hemoglobin concentrations may be affected by traditional factors, such as kidney function and iron status, as well as novel parameters, such as fibroblast growth factor 23 (FGF23).Methods-Here, we evaluated associations among erythropoietic, iron-related, and FGF23 parameters in a cohort of pediatric kidney transplant recipients, hypothesizing that multiple factors are associated with hemoglobin concentrations.Results-In a cross-sectional analysis of 59 pediatric kidney transplant recipients (median (interquartile range) age 16.3 (13.5, 18.6) years, median estimated glomerular filtration rate (eGFR) 67 (54, 87) ml/min/1.73 m 2 ), the median age-related hemoglobin standard deviation score (SDS) was −2.1 (−3.3, −1.1). Hemoglobin SDS was positively associated with eGFR and calcium, and was inversely associated with erythropoietin (EPO), mycophenolate dose, and total, but not intact, FGF23. In multivariable analysis, total FGF23 remained inversely associated with hemoglobin SDS, independent of eGFR, iron parameters, EPO, and inflammatory markers, suggesting a novel FGF23-hemoglobin association in pediatric kidney transplant patients. In a subset of patients with repeat measurements, only delta hepcidin was inversely associated with delta hemoglobin SDS. Also, delta EPO positively correlated with delta erythroferrone (ERFE), and delta ERFE inversely correlated with delta hepcidin, suggesting a possible physiologic role for the EPO-ERFE-hepcidin axis in the setting of chronic kidney disease (CKD). Conclusion-Our study provides further insight into factors potentially associated with erythropoiesis in pediatric kidney transplant recipients.

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Anemia after kidney transplantation

Guzzo

Atkinson

2022

Pediatr Nephrol

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Anemia and low-grade inflammation in pediatric kidney transplant recipients

Abstract: Anemia, but not elevated inflammatory indices, was associated with poor concomitant and subsequent graft function during a 10-year follow-up in pediatric RTx patients.

Cited by 4 publications

References 45 publications

Anemia after kidney transplantation: Does its basis differ from anemia in chronic kidney disease?

Anemia after kidney transplantation: Does its basis differ from anemia in chronic kidney disease?

Associations among erythropoietic, iron-related, and FGF23 parameters in pediatric kidney transplant recipients

Anemia after kidney transplantation

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